Theresa C Luddecke, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

371 Issued in CT

Practice address

26 Shenipsit Lake Rd
Tolland, CT 06084-2332

Phone

(860) 872-2999

NPI assigned

Feb 23, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1992078893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SHENIPSIT LAKE RD",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "06084",
            "telephone_number": "860-872-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SHENIPSIT LAKE RD",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060842332",
            "telephone_number": "860-872-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDDECKE",
        "first_name": "THERESA",
        "middle_name": "C",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marvelle Lisandra Lindo, APRN
• Deborah M. Lines
• Kathleen L Little, LCSW
• Gina Longo
• Geena Lovallo, LMFT
• Katlin Luu
• Conway Ma, DMD
• Marcia Lynn Machuga, RD-CDN
• Rachel Lynn Maclean, PA-C
• Kendal B Mainville, PT

• Occupational Therapy Assistant in Tolland, CT
• Providers in Tolland, CT by specialty
• Occupational Therapy Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.